Three members of a family in Liberia have contracted Ebola, two months after the country was declared free of the virus, health officials said on Friday.

The first documented case in the family was a 10-year-old boy who started showing symptoms last week, said a Liberian health official, speaking on the condition of anonymity.

After attending school on Monday and Tuesday, the boy was admitted to a hospital and was transported to an Ebola treatment unit on Wednesday, the official said.

The boy’s test came back positive on Thursday, as did subsequent tests for his father and a sibling, the official said, adding that at least seven health care workers may have treated him without the protective equipment essential for Ebola cases.

The media has been inaccurately reporting that countries in the outbreak zone are "Ebola free". The fact is that the WHO declares that "transmission has ended" in a country, and doesn't say that a country is free of Ebola.

MONROVIA (Reuters) - Liberia has placed 153 people under surveillance as it seeks to control a new Ebola outbreak in the capital more than two months after the country was declared free of the virus, health officials said.

Three Ebola cases emerged in Liberia on Friday. The first of the new patients was a 15-year-old boy called Nathan Gbotoe from Paynesville, a suburb east of the capital Monrovia. Two other family members have since been confirmed as positive and they are all hospitalized.

"We have three confirmed cases and have listed 153 contacts, and we have labeled them as high, medium and low in terms of the risk," Liberia's Chief Medical Officer Dr. Francis Kateh told Reuters late on Saturday.

__________________"Now, mark my words. So long as we are a young and virtuous people, this instrument will bind us together in mutual interests, mutual welfare, and mutual happiness. But when we become old and corrupt, it will bind us no longer" - Alexander Hamilton about the US Constitution.

Liberia: Ebola Strikes Again in Liberia - Three Confirmed Cases, One Probable Recorded

By Emmanuel Weedee-Conway
The Government of Liberia (GoL) through the Ministry of Health has confirmed the reemergence of the deadly Ebola Virus Disease (EVD) in the country.

Addressing a news conference at the weekend, Health Minister Dr. Bernice Dahn, announced that there are three confirmed cases and one probable case at the ELWA Ebola Treatment Unit (ETU) in Paynesville, outside Monrovia.

The first patient, a 10-year-old boy, Dr. Dahn pointed out that report from one of the country's reference laboratories showed that a blood sample from him tested positive of Ebola.

"The sample was taken from a patient who presented with some symptoms including fever, weakness and bleeding at a hospital in Monrovia on November 17. The hospital admitted and placed the patient in isolation. The patient's blood sample tested positive and confirmatory test was conducted and also tested positive for Ebola," Minister Dahn disclosed.

She said three other households of the boy have also been infested, but one of them has not been confirmed, though it is highly probable.

"The four patients and high risk contacts are in care at an Ebola Treatment Unit. The hospital is currently decontaminating the unit. All of the healthcare workers who came in contact with the patient have been notified," the health ministry boss said.

__________________"Now, mark my words. So long as we are a young and virtuous people, this instrument will bind us together in mutual interests, mutual welfare, and mutual happiness. But when we become old and corrupt, it will bind us no longer" - Alexander Hamilton about the US Constitution.

Two experts from the Centers for Disease Control and Prevention are set to travel to Liberia to try to determine the cause of new Ebola cases confirmed last week, more than two months after the country had been declared free of Ebola transmission for a second time, a Liberian health official said Monday.

Liberia requested U.S. assistance after three new cases were reported on Friday, said Dr. Francis Kateh, the country's chief medical officer and acting head of Liberia's Ebola Case Management System.

A 15-year-old boy has died of Ebola in Liberia less than three months after the country was declared free of the virus, officials have told the BBC.

He tested positive last week and died late on Monday at a treatment centre near the capital, Monrovia, Francis Kateh, the chief medical officer, said.

His father and brother are being treated for Ebola at the centre.

Liberia has seen more than 10,000 Ebola cases and more than 4,000 deaths since the West Africa outbreak began in 2013. The World Health Organization (WHO) has twice declared Liberia to be Ebola-free, once in May and again in September.

The teenage boy's mother and two other siblings have also been admitted to the treatment centre to be monitored, health ministry spokesman Sorbor George said.
He told the BBC that eight healthcare workers "who are at high risk because they came in direct contact with the boy" were also under surveillance.

The BBC's Jonathan Paye-Layleh in Monrovia says nearly 160 people are now being monitored since the new cases were confirmed last week.

__________________"Now, mark my words. So long as we are a young and virtuous people, this instrument will bind us together in mutual interests, mutual welfare, and mutual happiness. But when we become old and corrupt, it will bind us no longer" - Alexander Hamilton about the US Constitution.

DAKAR, Nov 24 (Thomson Reuters Foundation) - A failure to send a suspected Ebola patient directly to a specialist treatment unit in a fresh outbreak of the virus in Liberia may reflect fatigue and complacency among health workers, a health expert said on Tuesday.

Liberia has placed 153 people under surveillance after three Ebola cases emerged on Friday, more than two months after the West African country was declared free of the virus.

The first of the new patients was 15-year-old Nathan Gbotoe from Paynesville, a suburb east of the capital Monrovia, and his father and brother have since been confirmed as positive.

The teenager went to several health centres before being referred to an Ebola treatment unit and several health workers who cared for him may have not worn protective equipment, said Medecins Sans Frontieres (MSF) representative Carissa Guild.

"Normally with a surveillance system, if someone has signs and symptoms (of Ebola) they would not be hospitalised but immediately sent to an Ebola treatment centre to be tested."

"There were no cases for a while and Liberia was nearing the end of a 90-day period of heightened surveillance... it is quite possible that people were tired and got complacent," Guild said.

__________________"Now, mark my words. So long as we are a young and virtuous people, this instrument will bind us together in mutual interests, mutual welfare, and mutual happiness. But when we become old and corrupt, it will bind us no longer" - Alexander Hamilton about the US Constitution.

But another United Nations (UN) agency revealed that the mother of the first patient in the cluster showed signs of an earlier infection.

...Meanwhile, other details about the illness cluster surfaced in a Nov 23 situation update from UNICEF (UN Children's Fund), which was posted by ReliefWeb. Blood tests on the mother found high levels of Ebola antibodies, hinting at a recent recovery from the disease.

The group said elevated antibody levels were also seen in blood samples from the woman's 2-month-old baby, which UNICEF said tentatively suggests they came from the mother and not a recent infection.

Investigation conducted by this paper has established that unsafe blood transfusion is probably responsible for the new Ebola outbreak in Liberia.

A 15-year-old-boy was last weekend tested positive for Ebola and later pronounced dead on Tuesday. Dr. Francis Kateh, Chief Medical Officer of Liberia, said the boy's parents have also been tested positive for the virus and were undergoing observation.

The Ministry of Health and its partners are yet to disclose the source of the new outbreak, but a weeklong investigation conducted by this paper has established that blood recently transfused into the boy's mother at the Benson Hospital in Paynesville is the probable cause of the new Ebola infection.

Dozens of family members and neighbors told The NEWS that the boy's mother was the first person to have fallen ill in the family.

During a visit to the family's residence on Duport Road, Paynesville, family members disclosed that the boy's mother was admitted at Benson Hospital in Paynesville, after giving birth at home. They disclosed that the woman was given several pounds of blood at the facility.

According to them, the woman's husband and dead son fell sick days after she was discharged from Benson Hospital, noting that the boy's condition worsen thus resulting to his admittance to the John F. Kennedy Hospital.

__________________"Now, mark my words. So long as we are a young and virtuous people, this instrument will bind us together in mutual interests, mutual welfare, and mutual happiness. But when we become old and corrupt, it will bind us no longer" - Alexander Hamilton about the US Constitution.

They disclosed that the woman was given several pounds of blood at the facility.

Pounds of blood? Yeah, that certainly makes me think that this article is accurate.

Okay, maybe it's a translation error.

It's been reported that the mother is positive for antibodies, so she was exposed some how, somewhere. Maybe she did get it via transfusion, but if so, it seems to me that she would have been very ill, which she reportedly has not been.

I think I'll just wait to see what the CDC ends up saying after their investigation.

Pounds of blood? Yeah, that certainly makes me think that this article is accurate.

A pint's a pound the world around!

__________________"Now, mark my words. So long as we are a young and virtuous people, this instrument will bind us together in mutual interests, mutual welfare, and mutual happiness. But when we become old and corrupt, it will bind us no longer" - Alexander Hamilton about the US Constitution.

Liberia has gone complete 12 days without a new Ebola case since the first three cases one of which died later, the Incident Management System (IMS) has said.

Head of the IMS Tolbert Nyenswah said it was a significant reduction in the fight against the current outbreak of the Ebola in the country. Minister Nyenswah who appeared on ELBC Super Morning Show Tuesday also called on Liberians to ease the fears of the virus, urging them to follow all the precautionary measures introduced by the Health Ministry and her multilateral partners.

"The Duport road Cowfield situation is something that we are handling with high speed and critical importance, knowing that the Christmas season is around the corner and we want Liberians to have white Christmas season with happiness and people should not be afraid with the isolated situation we are faced with right now besides the three confirmed cases we spoke of earlier," he said.

__________________"Now, mark my words. So long as we are a young and virtuous people, this instrument will bind us together in mutual interests, mutual welfare, and mutual happiness. But when we become old and corrupt, it will bind us no longer" - Alexander Hamilton about the US Constitution.

If this proves to be accurate, then long term follow-ups are going to be critically important. But, as the article mentions, there's a real risk of stigmatizing survivors. Because the populations in the outbreak zone are mostly poorly educated, I can see that there could be real danger to people labeled as survivors.

If this theory is accurate, that means there are likely to be ongoing occurrences of new infections in small clusters. All it's going to take is for one of those incidences to get out of control for another major outbreak to happen.

An outbreak of Ebola in Liberia months after the country was declared free of the virus could have stemmed from a survivor who became infectious again after her immune system was weakened by pregnancy, experts investigating the case said.

The theory being discussed by U.S. and Liberian researchers and the World Health Organization raises concerns about whether it will be possible to bring to an end the worst Ebola epidemic in history, with as many as 17,000 survivors in West Africa acting as a potential human reservoir of the virus.

Ebola can lie dormant and hide in parts of the body such as the eyes and testicles, and rare cases of the virus re-emerging have been reported before.

If proven, the Liberia case would be the first known example of such a patient transmitting the virus to others.

...A main hypothesis for the new cases is Ophelia's "recrudescence", meaning a surge in virus replication from a dormant state, thought to be linked to a weakened immune system.

According to this scenario, Ophelia caught Ebola more than a year ago from her brother who died of a presumed Ebola infection in July 2014.

She is then believed to have recovered, but the virus flared up again this year while she was pregnant. Antibodies fighting the virus tend to drop towards delivery.

It is not known exactly how she might have transmitted the virus, which is found in bodily fluids, to her family. Despite her experiences, Ophelia is still alive.

...Experts said that the theory means there can be no let up in the monitoring of survivors for months or even years to come.

"The affected countries want to say they are Ebola-free but they need help with continuing surveillance and health care monitoring," said Jonathan Heeney, Professor of Comparative Pathology at Cambridge, who has written about human reservoirs of the virus.

"If you turn your back on this, you will see more of these cases."

Liberian officials have already ruled out the possibility that the virus was introduced from another country or from an animal, as happened in Guinea when the epidemic began in December 2013.

"It is the same strain of the virus that we've known here, that we have been dealing with in 2014," said Tolbert Nyenswah, head of Liberia's Ebola response, quoting initial findings.

The Liberia country head of the U.S. Centers for Disease Control, Desmond Williams, who is involved in the investigation, declined to comment, saying studies were ongoing.

The WHO said it assumed that the latest cases "arose as a result of a rare re-emergence of persistent virus from a survivor", but did not elaborate.

The sources say that another possible explanation is a secret sexual relationship between a family member and another survivor, although interviews have so far yielded few leads.

In an indication of how hard it is to monitor survivors in West Africa, Ophelia's husband denies that his family ever caught Ebola and says his son was bewitched. Doctors diagnosed him with the virus in November and he recovered.

"It's all a blind lie," Nathan Gbotoe Sr. told Reuters. He refuses to return to his Cow Field neighborhood for fear of coming under the same spell.

U.S. army scientists are trying to establish the origin of the new cases by reconstructing a genome from the family's virus samples and comparing it with others mapped since the epidemic began.

...Officials in Sierra Leone have reported other unexplained deaths, which may be Ebola relapses.

Some doctors are therefore urging closer monitoring of survivors, including women, to prevent future flare-ups but warn against policies that might lead to their being ostracized.